Clin Oral Invest (2006) 10: 1–7
DOI 10.1007/s00784-005-0031-2
REVIEW
Maria Eugenia Guerrero . Reinhilde Jacobs .
Miet Loubele . Filip Schutyser . Paul Suetens .
Daniel van Steenberghe
State-of-the-art on cone beam CT imaging for preoperative
planning of implant placement
Received: 30 May 2005 / Accepted: 13 December 2005 / Published online: 16 February 2006
# Springer-Verlag 2006
Abstract Orofacial diagnostic imaging has grown dramat-
ically in recent years. As the use of endosseous implants has
revolutionized oral rehabilitation, a specialized technique
has become available for the preoperative planning of oral
implant placement: cone beam computed tomography (CT).
This imaging technology provides 3D and cross-sectional
views of the jaws. It is obvious that this hardware is not in the
same class as CT machines in cost, size, weight, complexity,
and radiation dose. It is thus considered to be the examina-
tion of choice when making a risk–benefit assessment. The
present review deals with imaging modalities available for
preoperative planning purposes with a specific focus on the
use of the cone beam CT and software for planning of oral
implant surgery. It is apparent that cone beam CT is the
medium of the future, thus, many changes will be performed
to improve these. Any adaptation of the future systems
should go hand in hand with a further dose optimalization.
Keywords Cone beam computed tomography .
3-D imaging . Dental implants . Preoperative planning .
Volumetric tomography
M. E. Guerrero . R. Jacobs
Oral Imaging Center, School for Dentistry,
Oral Pathology and Maxillofacial Surgery,
Katholieke Universiteit Leuven,
Kapucijnenvoer 7,
Leuven 3000, Belgium
M. E. Guerrero . R. Jacobs (*) . D. van Steenberghe
Department of Periodontology, School for Dentistry,
Oral Pathology and Maxillofacial Surgery,
Katholieke Universiteit Leuven,
Leuven, Belgium
e-mail: Reinhilde.Jacobs@uz.kuleuven.be
Tel.: +32-16-332410
Fax: +32-16-332410
M. Loubele . F. Schutyser . P. Suetens
Medical Image Computing (ESAT+Radioloy),
Faculties of Engineering and Medicine,
UZ Gasthuisberg Leuven, Belgium
Oral rehabilitation by means of implants
The introduction of endosseous implant treatment has
initiated a revolution in oral rehabilitation for both partially
and fully edentulous patients. The clinical application of the
concept of osseointegration introduced in the midsixties [7]
soon revealed a predictable long term success [24]. Nowa-
days the use of implants is even popular for the replacement
of a single missing tooth [5].
Only an exhaustive and comprehensive radiological as-
sessment can provide the necessary information to select
such optimal sites and the number and size of implants to be
placed. The selection of the radiological technique should be
based on weighing the required image quality against the
radiation risks and costs involved [20]. In the perspective of
implant surgery, a correct identification of some anatomic
structures such us the mandibular canal is important to avoid
nerve damage or other perioperative complications.
In a position paper by the American Academy of Oral and
Maxillofacial Radiology, Tyndall and Brooks [39] recom-
mend that conventional cross-sectional tomography should
be the method of choice for most implant patients. Never-
theless, the authors state that currently there is no scientific
evidence for their recommendation. The ideal goal of the
radiographic examination is to achieve as much information
on the jawbone as possible and at the same time minimize the
radiation burden to the patient regarding the ALARA
principle (as low as reasonably achievable) and the costs.
Thus one could argue that while firm arguments are missing,
one should refrain from such supplementary imaging.
Another set of guidelines was introduced by the European
Association of Osseointegration (EAO) to avoid any over-
consumption of radiographic methods. These EAO guide-
lines also focus on cross-sectional imaging but leave to the
discretion of the clinician the use of 2-D imaging in minor
and/or established low risk surgery [12].
Computed tomography is a very common imaging tech-
nique, which allows the capture of information through a
spiral movement of the radiation source and the detectors
around the region of interest. For maxillofacial applications,
dedicated software was developed capable of reformatting
2

the data of the axial slices into panoramic images and
multiplanar cross-sectional images [38].
The advantages offered by computed tomography (CT)
technology are direct volumetric reconstructions, and faster
and easier data transformation for use in 3-D analyses
including functional imaging and real time imaging for
guiding interventional procedures [9].
On the other hand, CT sections impart relatively high
radiation doses to the patient. This radiation dose has to be
balanced by the required information for implant placement.
Its use can seldom be justified except for the imaging of large
jawbone segments. A further development and improvement
of CT equipment has inspired researchers and clinicians to
use it as low-dose CT [25]. This is where the cone beam CT
may offer a promising alternative approach.
Today the availability of real 3-D planning software,
which furthermore allows a reliable transfer to the surgical
field through drilling templates, helps the surgeon to
achieve an adequate oral implant placement [40].
The present review deals with imaging modalities avail-
able for preoperative planning purposes with a specific focus
on the use of the cone beam CT and software for planning of
oral implant surgery.
Cone beam computed tomography
A new type of CT machine devoted to the imaging of
maxillofacial structures based on the cone beam CT (CBCT)
technique was developed. Such cone beam system allows
the physician to acquire 3-D volume data in one rotation at
reasonably low levels of radiation dosage.
The CBCT technique was employed previously in radio-
therapy using fluoroscopic systems or modified simulators to
obtain cross-sections of the patient in the same geometric
conditions as the treatment. It was also used in vascular
imaging and in microtomography of small specimens for
biomedical and industrial applications [28]. Nowadays, ra-
diotherapy has become another relevant field for this
machine.
Megavoltage cone beam CT is an imaging technique for
image-guided radiotherapy that will enable radiation oncol-
ogists to enhance the care for cancer patients by generating
superior digital images and developing, simulating, and
verifying treatment plans [32]. Another application includes
stereotactic intracranial radiation therapy and prostate radi-
ation therapy [31]. Moreover, Sarkar et al. [33] have reported
cone beam CT application in several fields such as the space,
defense, automobile, nuclear industry, etc.
Mozzo et al. [28] presented the first commercial CBCT
system (NewTom DVT 9000, Quantitative Radiology,
Verona, Italy) devoted to maxillofacial imaging. This same
company has recently developed a new model named
NewTom 3G. Besides the latter, we can presently find four
other models: I-CAT (Imaging Sciences International,
Hatfield, USA), 3D Panoramic X-ray CT scanner PSR
9000N (Asahi Roentgen, Kyoto, Japan), CB MercuRay
(Hitachi Medico Technology Corporation, Kashiwa, Chiba,
Japan), and 3D Accuitomo (J. Morita, Kyoto, Japan).
Specifications of these cone beam devices devoted to den-
tistry are shown in Table 1.
The latter machine, the 3D Accuitomo was developed by
remodeling the “Multi-functional Panoramic Tomography”
(Scanora, Soredex, Helsinki, Finland). The 2003 annual

Table 1 Company, x-ray source voltage, X-ray source current (x time), scanning time, in plane voxel size and reconstruction increment for
each cone beam CT device
Cone beam Company Size of reconstructed X-ray source X-ray source Scanning Voxel size Min
CT devices image (diameter × voltage (kV) current (× time) time(s) (xy)c reconstruct.
height) mA(s)a Incr.1 or cubic2

3D Accuitomo J. Morita, 4×3, 4×4, 6×6 60–80 1–10 mA 18 0.125 0.1251

Kyoto, Japan (step 1kV) (step 0.1 mA)
NewTom 9000 Quantitative 13×13 110 15 mAb 72 0.29 0.21
NewTom 3G Radiology, 8×8, 10×10, 13×13, 110 15 mAb 36 0.16–0.42 0.161
Verona, Italy 15×15, 18×18,
22×22
I-CAT Imaging Sciences, 16×21, 16×13, 120 12.48 mAs, 10, 20, 40 0.2–0.4 0.22
Hatfield, Penn- 16×8, 16×8 23.87 mAs,
sylvania, USA 46.72 mAs
CB MercuRay Hitachi, Medical, 5.12×5.12, 60–120 10 or 15 mA 10 0.1–0.4 0.12
Kyoto, Japan 10.2×10.2, 15×15, (step 20 kV)
19×19
3D Panoramic Asahi Roentgen, 3.6×4, 4.1×4 60–100 2–12 mA 20, 30 0.1–0.15 0.1–0.152
X-ray CT scanner Kyoto, Japan (step 1 kV) (step 2 mA)
PSR 9000N
a
Because not all companies provide both the mA and the mAs, this distinction is made
b
This is the maximum mA setting. The mA is calculated based on the size of the patient head, calculated based on two scout views
c
These voxel sizes give the range of the different possibilities. There is no direct link between the information given about the reconstructed
size and these voxel sizes. Only a select combination of possibilities of both columns is possible

report of the 3D Accuitomo device found a high demand
of scans for implant treatment; 53% of the total cases
were devoted to oral implant presurgical and postsurgical
evaluation [37] (Fig. 1).
Various factors such as accuracy of the images and
radiation dose should dictate the choice of the most adequate
imaging technique. These elements will be discussed below.
Image quality on cone beam computed tomography
It was established that the generation of the CT hardware,
data acquisition, and parameters such as slice thickness and
interval of the reconstruction can determine the imaging
resolution. Schulze et al. [35] demonstrated high-contrast
structures with the CBCT device. In addition, several authors
[13, 18, 29] revealed excellent image acquisition for different
structures such as morphology of the mandible, location of
the inferior alveolar canal, and even for the relationship of
radioopaque templates to the bone.
Recently, CT and CBCT technique were compared to
assess which one was the most reliable. Kobayashi et al. [22]
confirmed the superiority of PSR 9000 cone beam CT to
spiral CT in terms of spatial resolution on cross-sectional
images.
Similar findings were reported when comparing images
from an anthropomorphic phantom taken by both the 3DX
Multi Image Micro CT (J. Morita) and the multidetector
Aquilion Multi-Slice CT (Toshiba Medical Co Ltd, Tokyo,
Japan). The superiority of the 3DX cone beam device in the
Fig. 1 Scans for implant
treatment
3
images’ resolution was demonstrated by means of a high
resolution score of the periodontal ligament space and the
lamina dura [13].
Honda et al. [16] compared helical CT with the Ortho-
CT and reported that the image quality obtained with the
Ortho-CT far surpassed that of the helical CT.
To achieve accurate information and sufficient detail for
preoperative planning of implant surgery, image quality of the
different devices should be analyzed. Hirsch et al. [15] made a
comparative investigation of the image quality using three
different X-ray systems. Five human cadaver heads were
examined by spiral CT (Somatom Emotion; Siemens,
Erlangen, Germany), cone beam CT (NewTom DVT 9000)
and 3D Accuitomo. Image quality assessment was performed
by five different observers using a 5-point rating scale. The
study revealed that the best image quality (mean score 4.62)
was achieved with the 3D Accuitomo. Spiral CT (mean score
2.78) and NewTom DVT 9000 (mean score 2.91) were
similar regarding the visibility of interesting structures.
Recently, Lascala et al. [23] have shown the reliability and
accuracy of the NewTom DVT 9000 when measuring
anatomical structures from CBCT images and compared
them with measurements of real distances of eight dry
skulls.
Brooks et al. [8] evaluated images of five unembalmed
cadaver heads and three living humans. The mandibular
canal could be seen easily in the scans of the humans but
was not readily visible with the default image reconstruc-
tion algorithm on the scans of the cadavers. This was the
result of the age of the specimens and the effect of the
4
thawing process on the visualization of the anatomical
structures.
Radiation doses using cone beam computed
tomography
In the field of diagnostic imaging, it is critical that the
patient-benefit of a procedure outweighs the risk of exposure
to ionizing radiation. Because one clear advantage of CBCT
over conventional CT scanners is its lower radiation dose, it
is essential to determine the effective dose of the various
CBCT scanners vs CT as they come into common use.
Mishima et al. [27] reported an advantage on the exposure
values of the 3D Panoramic X-ray CT scanner PSR 9000N.
The integral absorbed dose of radiation was less than 1/15
that of spiral CT, at least when the exposure condition of the
latter was optimized, to obtain a thinner slice width and a
more accurate data.
Ludlow et al. [26] have made a recent dosimetry
comparison between two cone beam devices: I-CAT and
NewTom 3G (Quantitative Radiology). The effective dose
for the former was 101.5 μSv using the 2005 tissue weights.
The operating parameters were 120 kVp and 22.85 mAs.
The effective dose for the NewTom 3G using the same
phantom and full field of view (FOV) was 56.5 μSv. The
operating factors were 110 kV and 8.1 mA as determined
automatically after a prescan of the phantom. From this
study, it seems that the effective dose from the I-CAT is 1.6–
1.8 times that of the NewTom 3G.
There are few surveys on dosimetry of the 3D Accuitomo.
Iwai et al. [19] estimated the effective dose of Ortho-CT, the
first prototype of this device. They found that the skin dose
was almost the same as with rotational panoramic radio-
graphy. This means an effective dose of approximately
20 μSv. Published effective doses from digital panoramic
radiography range from 4.7 to 14.9 μSv per scan [11]. Other
published data on nondigital panoramic radiographs puts the
effective dose as high as 26 μSv. Afterwards, Arai et al. [1]
found that the effective dose in one projection by the 3DX
MultiImage Micro-CT was 7.4 μSv. More research is
however needed to verify such results for all systems
available. Table 2 shows the equivalent background dose for
imaging techniques usually selected for the preoperative
planning of oral implants.
Table 2 Relative background radiation estimations for cone beam
versus spiral CT
Imaging technique Equivalent natural radiation
estimations (days) [11, 25, 26]
CT mandible + maxilla 38
CT mandible 33
CT maxilla 26
Cone beam CT 6–12
Panoramic radiograph 0.5–2
Shortcomings of cone beam computed tomography
It should be noted that cone beam CT devoted to the max-
illofacial area was designed to scan jaw bone lesions. Can-
cellous bone in particular is sharply visualized. Kobayashi et
al. [22] reported that one of the drawbacks of the 3D
Panoramic X-ray CT scanner PSR 9000 was its inability of
discriminating soft tissue because of its low contrast resolu-
tion. Furthermore, Heiland et al. [14] could not report
information about soft tissue quality. However, this device
provides essential information about the osseous morphology
for planning the placement of oral implants including cortical
integrity and thickness enlarged bone marrow spaces,
postextraction irregularities, and trabecular bone density.
When comparing CT with cone beam CT reconstructed
images, CT scans showed the most suitable images for
tumor-derived alterations due to their capacity for soft
tissue reconstruction. On the other hand, cone beam CT
could only visualize primary osseous tumors or soft tissue
tumors via osseous destruction of an impinging tumor [36].
One of the characteristics of these cone beam CT
systems is their option to select the region of interest in
accordance with the clinical demands. Unfortunately, not
all systems have this quality. The 3D Accuitomo, for
instance, only allows scanning of limited volumes (Ø 4 cm,
h 3 cm). One of the machines that have large field of view
is NewTom DVT 9000, which in addition to both jaws, can
display both temporo-mandibular joints and the sinus.
It is known that noise decreases with increasing voxel
size and with increasing beam current [2]. Therefore, a high
quality of reconstructed images is related to less noise with
neither streak nor ring artifact findings. Metallic dental
fillings may create artifacts in cone beam CT images. In
addition, Mozzo et al. [28] found that the lower absorbed
dose in the NewTom DVT 9000 was explained partially by
the slightly higher level of accepted noise in the images.
It can also be argued that the image noise of CB
MercuRay is higher than of conventional helical CT. This
is likely to result from the noise of the image intensifier and
scattered radiation of this system [2].
Moreover, by irradiating only one site or area, such as
with the cone beam CT, projections acquired do not contain
the entire object. Reconstructed images thus suffer from
truncation artifacts. To solve this problem, Wiegert et al.
[44] have presented a novel method to avoid such truncated
artifacts using a truncation-free volume data for accurate
compensation of the artifacts.
In the CBCT systems that were developed, detection was
accomplished by the combination of an X-ray image
intensifier and Charge Coupled Device camera. This type
of detector was shown to be an effective aid on imaging
technology for acquiring 3-D data for diagnostic tasks such
as implant treatment planning [17, 45]. At the same time, a
prototype CBCT with a flat panel-type detector (FPD) was
developed and compared with an image-intensifier detector
[3]. Once the results showed that FPD system has a strong
potential for use as a cone beam CT detector, they have
evaluated the system performance. High-resolution recon-

Fig. 2 Image segmentation to
construct 3-D models of the
bone and prosthesis
structed images were reported in this study. Finally, they
concluded that a FPD offers improved precision in maxillary
imaging [4].
Case report
Axial, sagittal and coronal images of a dry mandible were
acquired with 3D Accuitomo (see Fig. 1). The first scan
was taken while the partial edentulous mandible was
positioned wearing the scan template. The exposure
parameter settings selected included 70 Kv and 2 mA. A
second scanning of the template alone was also required.
Scanning parameters were now lowered to 60 kV and 1 mA
to allow visibility of the template. The exposure time was
of 17.5 s and a 360-degree-turn was selected.
The bone in the image was semi-automatically segmen-
ted with the Amira 3D (Mercury Computer System, Berlin,
Fig. 3 Osseous tissues in rela-
tion to the position of denture
teeth
5
Germany). Automatic bone segmentation was not possible
because of a bias field of the image intensity (Fig. 2).
Three-dimensional computed tomography-based
planning
Various studies have investigated the efficiency of preoper-
ative CTs for the success of surgical treatments. Precise
insertion of the implant can be obtained through the use of
image-based surgical templates, modified conventional
tomography, CT-scans, and 3-D computer-assisted planning
of oral implant surgery [6, 10, 21, 30]. These methods are
helpful but not sufficient to accurately transfer the preoper-
atively acquired data to the patient.
Advances in computer technology have enabled the
development of systems that can assist the clinician in diag-
nosis, treatment planning, and the treatment itself. Three-
6
dimensional computer-assisted interactive implant planning
has the accuracy and reliability required for clinical use. Two
methods for a computed-based transfer are available: navi-
gation and stereolithographic drill guides.
Navigation was primarily used in neurosurgery, ortho-
pedic surgery, otorhinolaryngological surgery, and maxil-
lofacial surgery [43]. This technology offers the surgeon
precise views of preplanned locations in the patient’s jaw
during surgery, demonstrating an accurate transfer of the
preoperative plan to the patient [42].
Another approach is the use of stereolithographic drill
guides. Some authors [40] reported angular deviation usually
bellow 3° and linear deviations mainly below 2.5 mm for
zygomatic implants when employing stereolithographic drill
guides. Furthermore, several authors demonstrate how
implant placement was improved by using stereolithograph-
ic surgical guides [34, 41].
Different softwares for preoperative planning purposes
are available. Procera Software (Nobelbiocare, Göteborg,
Sweden) allows the clinicians to evaluate the osseous tissues
in relation to the position of denture teeth (Fig. 3). Vimplant
(CyberMed, Inc, Seoul, Korea) is another software program
that allows interactive 2-D and 3-D diagnosis and treatment
planning and could help the clinician to easily and quickly
visualize all of the images, which may exist in the film
version of the CT Scan. There are several more but this goes
beyond the goal of the present paper.
Furthermore, several navigation softwares are available.
VISIT was developed at the Department of Biomedical
Engineering and Physics (University of Vienna, General
Hospital, Vienna, Austria).
RoboDent (GmbH, Berlin, Germany) and Stryker
Leibinger (Freiburg, Germany) are implant planning and
navigation systems. With the help of 3-D computer guid-
ance, oral implants can be placed according to the planning
with high precision.
Conclusions
The use of 2-D or 3-D CT image-based planning for oral
implant treatment is now widespread. These methods are
helpful in the preoperative evaluation of the surgical site.
They also enhance the surgeons’ knowledge of specific
anatomic situation criteria.
Dose radiation received from a reformatted CT exam-
ination of the mandible or maxilla is the same whether a
single implant site or multiple sites are evaluated. There-
fore, CT will be indicated only for anatomically difficult
cases or with extensive implant treatment.
The wide range of potential applications of CBCT was
shown in several clinical cases. Thus, CBCT provides an
option for digital 3-D imaging with a significantly smaller
effective dose than that achieved with CT and is within the
range of traditional dental imaging modalities.
Image quality and radiation dose in CBCT devices makes
these devices very attractive for presurgical planning
approaches. Considering the increased interest in cone
beam CT, further adaptations, optimalizations, and new
developments will soon follow. The future may offer fully
adaptable systems regarding exposure parameters and scan-
ning volumes and image quality improvements. The evolu-
tion in hardware will be followed by a refinement of the
software including dedicated surgical tools such as preop-
erative implant planning software.
Acknowledgement M. E. Guerrero is a scholarship holder of the
Belgian Technical Cooperation. D. van Steenberghe is holder of the
P. I. Brånemark Chair in Osseointegration.
References
1. Arai Y, Honda K, Iwai K, Shinoda K (2001) Practical model
“3DX” of limited cone-beam X-ray CT for dental use. Int
Congr Ser 1230:713–718
2. Araki K, Maki K, Seki K, Sakamaki K, Harata Y, Sakaino R,
Okano T, Seo K (2004) Characteristics of a newly developed
dentomaxillofacial X-ray cone beam CT scanner (CB Mercu-
Ray): system configuration and physical properties. Dentomax-
illofac Radiol 33:51–59
3. Baba R, Konno Y, Ueda K, Ikeda S (2002) Comparison of flat-
panel detector and image-intensifier detector for cone-beam CT.
Comput Med Imaging Graph 26:153–158
4. Baba R, Ueda K, Okabe M (2004) Using a flat-panel detector in
high resolution cone beam CT for dental imaging. Dentomax-
illofac Radiol 33:285–290
5. Belser U, Schmit B, Higginbottom F, Buser D (2004) Outcome
analysis of implant restorations located in the anterior maxilla:
A review of the literature. Int J Oral Maxillofac Implants
19:30–42 (Suppl)
6. Besimo C, Lambrecht JT, Guindy JS (2000) Accuracy of implant
treatment planning utilizing template-guided reformatted com-
puted tomography. Dentomaxillofac Radiol 29:46-51
7. Brånemark P-I, Breine U, Adell R, Hanson Bo, Lindström J,
Ohlsson A (1969) Intraosseous anchorage of dental prostheses.
Scand J Plast Reconstr Surg 3:81–100
8. Brooks SL, Beason R, Sarment D, Sukovic P (2004) Implant
imaging with the I-CAT cone-beam CT-a progress report. Int
Congr Ser 1268:1184–1186
9. Cavalcanti MGP, Rocha SS, Vannier MW (2004) Craniofacial
measurements based on 3D-CT volume rendering: implications
for clinical applications. Dentomaxillofac Radiol 33:170–176
10. Fortin T, Coudert J, Champleboux G, Sautot P, Lavallee
S (1995) Computer-assisted dental implant surgery using
computed tomography. J Image Guid Surg 1:53–58
11. Gijbels F, Jacobs R, Debaveye D, Verlinden S, Bogaerts R,
Sanderink G (2005) Dosimetry of digital panoramic imaging.
Part 1: patient exposure. Dentomaxillofac Radiol 34:145–149
12. Harris D, Buser D, Dula K et al (2002) E.A.O Guidelines for
the use of Diagnostic Imaging in Implant Dentistry. Clin Oral
Implants Res 566–570
13. Hashimoto K, Arai Y, Iwai K, Araki M, Kawashima S,
Terakado M (2003) A comparison of a new limited cone beam
computed tomography machine for dental use with a multi-
detector row helical CT machine. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 95:371–377
14. Heiland M, Schmelzle R, Hebecker A, Schulze D (2004)
Intraoperative 3D imaging of the facial skeleton using the
SIREMOBIL Iso-C3D. Dentomaxillofac Radiol 33:130–132
15. Hirsch E, Graf H-L, Hemprich A (2003) Comparative
investigation of image quality of three different X-ray
procedures. Dentomaxillofac Radiol 32:201–211
16. Honda K, Arai Y, Iwai K, Hasimoto K, Saito T, Shinoda K
(2000) Fundamental efficiency of new-style limited cone-beam
CT (3DX). Comparison with Helical CT. Jpn J Tomogr 27:17–22

17. Honda K, Larheim A, Johannessen S, Arai Y, Shinoda K,
Westesson P (2001) Ortho cubic super high resolution
computed tomography: a new radiographic technique with
application to the temporomandibular joint. Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 91:239–243
18. Ito K, Gomi Y, Sato S, Arai Y, Shinoda K (2001) Clinical
application of a new compact CT system to assess 3-D images
for the preoperative treatment planning of implants in the
posterior mandible. A case report. Clin Oral Implants Res
12:539–542
19. Iwai K, Arai Y, Nishizawa K,Tammisalo E, Hashimoto K,
Shinoda K (1998) Estimation of radiation doses from ortho
cubic super high resolution CT. Dentomaxillofac Radiol 27
[Suppl 1]:39
20. Jacobs R, Gijbels F (2000) Oral Imaging 2000. KULeuven,
Dept Periodontology, Leuven, pp 4–8
21. Jacobs R, Adriansens A, Verstreken K, Suetens P, van
Steenberghe D (1999) Predictability of a three-dimensional
planning system for oral implant surgery. Dentomaxillofac
Radiol 28:105–111
22. Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A (2004)
Accuracy in measurement of distance using limited cone-beam
computerized tomography. Int J Oral Maxillofac Implants
19:228–231
23. Lascala CA, Panella J, Marques MM (2004) Analysis of the
accuracy of linear measurements obtained by cone beam
computed tomography (CBCT-NewTom). Dentomaxillofac
Radiol 33:291–294
24. Lindquist LW, Carlsson GE, Jemt T (1996) A prospective 15-
year follow-up study of mandibular fixed prostheses supported
by osseointegrated implants. Clinical results and marginal bone
loss. Clin Oral Implants Res 7:329–336
25. Loubele M, Schutyser F, Debaveye D, Jacobs R, Bogaerts R,
Maes F, van Cleynenbreugel J, Vandermeulen D, Marchal G,
Suetens P (2005) Radiation dose versus image quality for low-
dose CT protocols of the head for maxillofacial surgery and
dental implant planning. Radiat Prot Dosim (International
workshop on optimisation of dose and performance in
interventional and digital imaging-DIMOND III, March 25–
27, 2004, Leuven, Belgium) (in press)
26. Ludlow JB, Brooks SL, Davies-Ludlow LE, Howerton WB
(2005) Dosimetry of 3 CBCT units for oral and maxillofacial
radiology. 15th International Congress of DentoMaxilloFacial
Radiology. OP22, p 53
27. Mishima A, Kobayashi K, Yamamoto A, Kimura Y, Tanaka M
(2001) Comparison of patient radiation dose from dental CT
and spiral CT. Symposium of high technology research center
in Tsurumi University School of Dental Medicine. Nagasue
Shoten, Yokohama, Japan, pp 171–172
28. Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA
(1998) A new volumetric CT machine for dental imaging based
on the cone-beam technique: preliminary results. Eur Radiol
8:1558–1564
29. Nakagawa Y, Kobayashi K, Mishima, Ishii H, Asada K,
Ishibashi K (2002) Preoperative application of limited cone
beam computerized tomography as an assessment toll before
minor oral surgery. Int J Oral Maxillofac Surg 31:322–327
30. Naitoh M, Arjji E, Okumura S, Ohsaki C, Kurita K, Ishigama T
(2000) Can implants be correctly angulated based on surgical
templates used for osseointegrated dental implants? Clin Oral
Implants Res 11:409–414
7
31. Oldham M, Letourneau D, Watt L, Chen P, Martinez A, Wong J
(2003) On-line volumetric CT-guided radiation theraphy. Int
J Rad Onc Biol Phys 57:184 (Suppl)
32. Pouliot J, Xia P, Aubin M, Verhey L, Bani-Hashemi A,
Ghelmansarai F, Mitschke M, Svatos M (2003) Low-dose
megavoltage cone beam CT for dose-guided radiation therapy.
Int J Rad Onc Biol Phys 57:183 (Suppl)
33. Sarkar PS, Sinha A, Kashyap Y, More MR, Godwal BK (2004)
Development and characterization of a 3D cone beam tomog-
raphy system. Nucl Instr Meth A 524:377–384
34. Sarment D, Sukovic P, Clinthorne N (2003) Accuracy of
implant placement with astereolithographic surgical guide. Int
J Oral Maxillofac Implants 18:571–577
35. Schulze D, Heiland M, Schmelzle R, Rother UJ (2004)
Diagnostic possibilities of cone-beam computed tomography
in the facial skeleton. Int Congr Ser 1268:1179–1183
36. Schulze D, Heiland M, Thurmann H, Adam G (2004b)
Radiation exposure during midfacial imaging using 4- and
16-slice computed tomography, cone beam computed tomog-
raphy systems and conventional radiography. Dentomaxillofac
Radiol 33:83–86
37. Shinoda K, Honda K, Matsumoto K, Arai Y (2004) Annual
report of limited cone beam computed tomography (3D Accu-I-
Tomo) from 3000 cases at Nihon University dental hospital in
2003. Int Congr Ser 1268:1187–1191
38. Schwarz MS, Rothman SL, Chafetz N, Rhodes M (1989)
Computed tomography in dental implantation surgery. Dent
Clin North Am 33:555–597
39. Tyndall AA, Brooks SL (2000) Selection criteria for dental
implant site imaging: a position paper of the American
Academy of Oral and Maxillofacial Radiology. Oral Surg
Oral Med Oral Pathol Oral Radiol Endod 89:630–637
40. van Steenberghe D, Naert I, Andersson M, Brajnovic I, Van
Cleynenbreugel J, Suetens P (2002) A custom template and
definitive prosthesis allowing immediate implant loading in the
maxilla: a clinical report. Int J Oral Maxillofac Implants
17:663–670
41. van Steenberghe D, Ericsson I, Van Cleynenbreugel J,
Schutyser F, Brajnovic I, Andersson M (2004) High precision
planning for oral implants based on 3-D CT scanning. A new
surgical technique for immediate and delayed loading. Appl
Osseointegration Res 4:27–31
42. Wanschitz F, Birkfellner W, Watzinger F, Schopper C, Patruta
S, Kainberger K, Figl M, Kettenbach J, Bergmann H, Ewers R
(2002) Evaluation of accuracy of computer aided intraoperative
positioning of endosseous oral implants in the edentulous
mandible. Clin Oral Implants Res 13:59–64
43. Watzinger F, Wanschitz F, Wagner A, Enislidis G, Millesi W,
Baumann A, Ewers R (1997) Computer-aided navigation in
secondary reconstruction of post-traumatic deformities of the
zygoma. J Craniomaxillofac Surg 25:198–202
44. Wiegert J, Bertram M, Wulff J, Schafer D, Weese J, Netsch T,
Schomberg H, Rose G (2004) 3D ROI imaging for cone-beam
computed tomography. Int Congr Ser 1268:7–12
45. Ziegler CM, Woertche R, Brief J, Hassfeld S (2002) Clinical
indications for digital volume tomography in oral and maxil-
lofacial surgery. Dentomaxillofac Radiol 31:126–130